Healthcare Provider Details

I. General information

NPI: 1659352862
Provider Name (Legal Business Name): MIGUEL J. QUINTERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 S 20TH ST
PITTSBURGH PA
15203-2052
US

IV. Provider business mailing address

144 S 20TH ST
PITTSBURGH PA
15203-2052
US

V. Phone/Fax

Practice location:
  • Phone: 412-488-7454
  • Fax: 412-488-7795
Mailing address:
  • Phone: 412-488-7454
  • Fax: 412-488-7795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD034274L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: